F&S reviews最新文献

{"title":"Systematic review of racial and ethnic disparities in reproductive endocrinology and infertility: where do we stand today?","authors":"Tia Jackson-Bey M.D., M.P.H. ,&nbsp;Jerrine Morris M.D., M.P.H. ,&nbsp;Elizabeth Jasper Ph.D. ,&nbsp;Digna R. Velez Edwards Ph.D., M.S. ,&nbsp;Kim Thornton M.D. ,&nbsp;Gloria Richard-Davis M.D. ,&nbsp;Torie Comeaux Plowden M.D., M.P.H.","doi":"10.1016/j.xfnr.2021.05.001","DOIUrl":"10.1016/j.xfnr.2021.05.001","url":null,"abstract":"<div><h3>Objective</h3><p>To conduct a comprehensive review of racial and ethnic health disparities in infertility care and treatment.</p></div><div><h3>Evidence Review</h3><p>Systematic literature searches were performed in PubMed and Embase from inception to April 2021. Studies were eligible for inclusion if they were original research performed in humans, observational study design, focused on circumstances contributing to infertility, access to infertility care, or outcomes of infertility treatment, and provided relevant information on racial or ethnic groups. Titles and abstracts were reviewed independently by two reviewers to identify pertinent articles. In addition, references of included articles were screened.</p></div><div><h3>Result(s)</h3><p>The PubMed search yielded 2,113 articles. An additional 2,301 articles were found in the Embase search. In total, 4,414 articles were screened on the basis of title and, where necessary, abstract. Thirty-four were found to meet the inclusion criteria and included in this review. Three additional studies were found from searching references of the included articles, resulting in 37 articles for discussion: 26 retrospective cohort studies, 2 prospective cohort studies, and 9 cross-sectional studies. The overall consensus in the literature is that reproductive health disparities on the basis of race and ethnicity impact fertility, access to care, and fertility treatment outcomes.</p></div><div><h3>Conclusion(s)</h3><p>Racial and ethnic differences in access to full-spectrum reproductive care, including infertility evaluation and treatment, remain. Despite access to infertility treatment, disparate treatment outcomes persist. Intrinsic and extrinsic factors, such as the institutionalization of racism and discrimination within medicine, remain influential in the diagnosis, care, and treatment outcomes of individuals with infertility. To address these inequities, we should mitigate provider bias, fund high-quality health disparity research, improve patient reproductive health knowledge, and advocate for increased access to treatment for all.</p></div>","PeriodicalId":73011,"journal":{"name":"F&S reviews","volume":"2 3","pages":"Pages 169-188"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.xfnr.2021.05.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42314428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shared genetics between nonobstructive azoospermia and primary ovarian insufficiency","authors":"Lauren Verrilli M.D. ,&nbsp;Erica Johnstone M.D., M.H.S. ,&nbsp;Kristina Allen-Brady Ph.D., M.S.P.H, M.P.T. ,&nbsp;Corrine Welt M.D.","doi":"10.1016/j.xfnr.2021.04.001","DOIUrl":"10.1016/j.xfnr.2021.04.001","url":null,"abstract":"<div><h3>Objective</h3><p>Primary ovarian insufficiency<span><span><span> (POI) and nonobstructive azoospermia<span><span> (NOA) both represent disease states of early, and often complete, failure of gametogenesis. Because </span>oogenesis and </span></span>spermatogenesis share the same conserved steps in meiosis I, it is possible that inherited defects in meiosis I could lead to shared causes of both POI and NOA. Currently, known genes that contribute to both POI and NOA are limited. In this review article, we provide a </span>systematic review of genetic mutations in which both POI and NOA phenotypes exist.</span></p></div><div><h3>Evidence Review</h3><p>A PubMed literature review was conducted from January 1, 2000, through October 2020. We included all studies that demonstrated human cases of POI or NOA due to a specific genetic mutation either within the same family or in separate families.</p></div><div><h3>Results</h3><p>We identified 33 papers that encompassed 10 genes of interest with mutations implicated in both NOA and POI. The genes were all involved in processes of meiosis I.</p></div><div><h3>Conclusion</h3><p>Mutations in genes involved in processes of meiosis I may cause both NOA and POI. Identifying these unique phenotypes among shared genotypes leads to biologic plausibility that the key error occurs early in gametogenesis with an etiology shared among both male and female offspring. From a clinical standpoint, this shared relationship may help us better understand and identify individuals at a high risk of gonadal failure within families and suggests that clinicians obtain the history of opposite-sex family members when approaching a new diagnosis of POI or NOA.</p></div>","PeriodicalId":73011,"journal":{"name":"F&S reviews","volume":"2 3","pages":"Pages 204-213"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.xfnr.2021.04.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40385274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phthalates in albumin from human serum: implications for assisted reproductive technology","authors":"Jennifer R. Hughes Ph.D. ,&nbsp;Sandra Soto-Heras Ph.D. ,&nbsp;Charles H. Muller Ph.D. ,&nbsp;David J. Miller Ph.D.","doi":"10.1016/j.xfnr.2020.12.002","DOIUrl":"10.1016/j.xfnr.2020.12.002","url":null,"abstract":"<div><p><span>Albumin, a vital protein in cell culture systems, is derived from whole blood or blood products. The culture of human gametes and developing embryos for </span>assisted reproductive technology<span> (ART) uses albumin of human origin. Human serum albumin<span> (HSA) is derived from expired blood obtained from blood banks. This blood has been stored in polyvinyl chloride bags made clear and flexible with di-2-ethylhexyl phthalate (DEHP). However, DEHP can leach from the bags into stored blood and cofractionate with HSA during albumin isolation. DEHP and its metabolite, mono-ethylhexyl phthalate, are known endocrine disruptors that are reported to have negative effects when directly supplemented in media for in vitro fertilization using gametes from a variety of animals. Therefore, the contamination of ART media with DEHP and mono-ethylhexyl phthalate through HSA supplementation may affect the outcomes of ART procedures. Although the embryology laboratory is strictly monitored to prevent a wide variety of contaminations, phthalate contamination of HSA has not been broadly examined. This review outlines the function of HSA in ART procedures and the production of HSA from whole blood. Finally, the review highlights the effects of acute phthalate exposures on gametes during in vitro procedures. Phthalates found in human serum albumin are present in media used for ART at levels that impair developmental endpoints in model species.</span></span></p></div>","PeriodicalId":73011,"journal":{"name":"F&S reviews","volume":"2 2","pages":"Pages 160-168"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.xfnr.2020.12.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40648485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 may affect male fertility but is not sexually transmitted: a systematic review","authors":"Ilan Tur-Kaspa M.D. ,&nbsp;Tomer Tur-Kaspa ,&nbsp;Grace Hildebrand B.A. ,&nbsp;David Cohen M.D.","doi":"10.1016/j.xfnr.2021.01.002","DOIUrl":"10.1016/j.xfnr.2021.01.002","url":null,"abstract":"<div><h3>Objective</h3><p>To determine if SARS-CoV-2, which has led to the rapidly spreading COVID-19 global pandemic, is sexually transmitted. Since the putative receptor for the virus is identified in reproductive organs, it is also important to examine if COVID-19 may affect human fertility.</p></div><div><h3>Evidence Review</h3><p>A systematic review of English publications was conducted up to December 11, 2020 in PubMed, NIH iCite COVID-19 portfolio, Cochrane Library, and Google Scholar databases, searching for SARS-CoV-2 in the testes; seminal, prostatic, and vaginal fluids; and cervical smears. A total of 1,997 records were identified, duplicates were removed, and 1,490 records were reviewed for eligibility by examining titles and abstracts. Subsequently, 202 full-text relevant articles were reviewed by 2 independent reviewers. Forty-seven studies (literature reviews, editorials, and guidelines) were assessed qualitatively, and 23 studies that tested the male and female reproductive tracts of patients with COVID-19 for SARS-CoV-2 were quantitatively analyzed.</p></div><div><h3>Results</h3><p>No epidemiological investigations to date have described evidence suggesting that COVID-19 is an STD. While angiotensin-converting enzyme 2 receptor is found in the reproductive organs, the lack of co-expression of the TMPRSS2 modulatory protein, required for SARS-CoV-2 cell entry, in testicular cells, sperm, or oocytes, argues against the hypothesis that gametes transmit SARS-CoV-2. Molecular detection studies of SARS-CoV-2 RNA in the male and female reproductive tracts were summarized: 98.0% (293/299) of the seminal fluids, 16/17 testicular biopsies, all 89 prostatic fluids, 98.3% (57/58) of the vaginal fluids, all 35 cervical smears, and all 16 oocyte samples tested negative for SARS-CoV-2. None of the studies confirmed sexual transmission of SARS-CoV-2. Nonetheless, COVID-19 may have detrimental effects on male reproduction by inducing orchitis and/or decreasing testosterone levels, sperm counts, and motility.</p></div><div><h3>Conclusion</h3><p>On the basis of the current worldwide published information, COVID-19 is not an STD. This information is important for clinicians, proposed guidelines for public health, U.S. Food and Drug Administration guidelines for gamete and tissue donor eligibility, and fertility treatments. Universal precautions, currently practiced worldwide, are adequate and sufficient at this time to prevent the transmission of known or unknown viral infections. We suggest that recovered patients of COVID-19, especially those with infertility, should be evaluated for their ovarian and testicular function.</p></div>","PeriodicalId":73011,"journal":{"name":"F&S reviews","volume":"2 2","pages":"Pages 140-149"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.xfnr.2021.01.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25349155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to fertility care for racial/ethnic minority groups: a qualitative systematic review","authors":"Abirami Kirubarajan B.H.Sc., M.Sc ,&nbsp;Priyanka Patel M.Sc., M.D ,&nbsp;Shannon Leung B.H.Sc., M.P.H ,&nbsp;Theebhana Prethipan B.H.Sc ,&nbsp;Sony Sierra M.Sc., M.D","doi":"10.1016/j.xfnr.2021.01.001","DOIUrl":"10.1016/j.xfnr.2021.01.001","url":null,"abstract":"<div><h3>Objective</h3><p>To characterize patient-reported barriers to equitable fertility care for racial/ethnic minority groups</p></div><div><h3>Evidence Review</h3><p><span>We conducted a systematic review of the following 6 databases based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines: Ovid Medline, Embase, CINAHL, Cochrane Library, </span><span>ClinicalTrials.Gov</span><svg><path></path></svg><span>, and PsycInfo. Citations of full-text articles were also manually searched in the Scopus database. Original research studies were eligible for inclusion if they reported patient-reported outcomes regarding racial/ethnic equity or cultural competence in fertility care. All racial and ethnic groups, including Black, Hispanic, South/East Asian, Pacific Islander, and Indigenous groups, were eligible for inclusion. Screening, extraction, and appraisal were completed in duplicate by 2 independent reviewers. The Risk of Bias Instrument for Cross-Sectional Surveys of Attitudes and Practices and the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research were used to assess the risk of bias and methodological quality.</span></p></div><div><h3>Results</h3><p>Of 2,921 original database citations, we included 17 studies, which encompassed 3,743 patients from racial/ethnic minority and immigrant/refugee groups. The key patient-reported barriers included stigmatization of fertility care, lack of infertility knowledge, language barriers, discrimination, and lack of institutional trust. These barriers can create psychological distress for patients as well as prevent help-seeking for infertility. As such, the different approaches for equitable care included provision of multilingual services, involvement of physicians of diverse backgrounds, incorporation of preferred traditional healers, awareness of religious beliefs, and screening for psychosocial services. However, it is important to ensure that fertility providers do not inadvertently stereotype patients or rely on blanket assumptions. An open-ended approach to cultural humility is recommended.</p></div><div><h3>Conclusions</h3><p>It is important for healthcare providers to consider the unique barriers for fertility care for racial and ethnic minority groups. This review describes a number of implementable solutions for equitable fertility care.</p></div>","PeriodicalId":73011,"journal":{"name":"F&S reviews","volume":"2 2","pages":"Pages 150-159"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.xfnr.2021.01.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"113382138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of oocyte quality in assisted reproductive technology outcomes: a systematic review","authors":"Nicole M. Fischer M.P.H.,&nbsp;Ha Vi Nguyen M.D.,&nbsp;Bhuchitra Singh M.D., M.P.H., M.H.S.,&nbsp;Valerie L. Baker M.D.,&nbsp;James H. Segars M.D.","doi":"10.1016/j.xfnr.2021.03.001","DOIUrl":"10.1016/j.xfnr.2021.03.001","url":null,"abstract":"<div><h3>Objective</h3><p>To survey and assess modern methodologies used to test oocyte quality that have prognostic value in predicting assisted reproductive technology outcomes</p></div><div><h3>Evidence Review</h3><p><span>Following the Preferred Reporting Items for Systematic Reviews<span> and Meta-Analyses guidelines, we surveyed the English-language literature between January 1, 2010, and December 31, 2019, using PubMed, Scopus, and Embase databases. Two reviewers screened for articles focusing on oocyte quality markers that predict assisted reproductive technology outcomes, including embryo quality as well as </span></span>fertilization<span><span>, implantation, pregnancy, continued pregnancy, and live birth rates. Articles that did not mention oocytes or those that focused on nonhuman subjects, oocyte aging, </span>oocyte maturation, embryo quality, interventions, or specific clinical diagnoses (endometriosis and polycystic ovarian syndrome) were deemed outside the scope of this analysis and excluded.</span></p></div><div><h3>Results</h3><p>Twenty-six relevant articles were identified, including 19 prospective and 7 retrospective studies (n = 2,210 patients). We identified 3 general approaches for oocyte quality assessment: morphological evaluation (11 articles), genomics and proteomics (13 articles), and artificial intelligence (2 articles). Morphological assessment did not show a consistent pattern of predictive value of predicting in vitro fertilization outcomes (7 articles in favor of its predictive value, 4 against). A considerable proportion of genomic and proteomic articles identified promising biomarkers that may predict pregnancy and live birth (12 in favor, 1 against). Machine learning is a rapidly growing frontier that minimizes subjectivity while potentially improving predictive ability (2 in favor).</p></div><div><h3>Conclusion</h3><p>Although there remains a lack of consensus on optimal methods to predict reproductive success, machine learning and genomics demonstrate promise in improving the understanding of oocyte quality assessment and prognostication.</p></div>","PeriodicalId":73011,"journal":{"name":"F&S reviews","volume":"2 2","pages":"Pages 120-139"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.xfnr.2021.03.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"95763307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with searching for people related through donor conception among donor-conceived people, parents, and donors: a systematic review","authors":"Astrid Indekeu Ph.D. ,&nbsp;A.Janneke.B.M. Maas Ph.D. ,&nbsp;Emily McCormick M.P.H ,&nbsp;Jean Benward M.S. ,&nbsp;Joanna E. Scheib Ph.D.","doi":"10.1016/j.xfnr.2021.01.003","DOIUrl":"10.1016/j.xfnr.2021.01.003","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;p&gt;To review the body of literature to summarize the existing knowledge about factors that shape gamete donor linking and discuss their implications for clinical care and future research. Recent changes in policy, practice, and technology have made it possible for individuals connected through donor conception—donor-conceived (DC) people, parents, and donors—to find and contact one another.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Evidence Review&lt;/h3&gt;&lt;p&gt;A bibliographic search of English, French, German, Spanish, and Dutch language peer-reviewed publications was performed according to the Preferred Reporting Items for Systematic Reviews&lt;span&gt;&lt;span&gt; and Meta-Analyses guidelines using the electronic databases PubMed, EMBASE, and Web of Science Core Collection. The inclusion criteria were as follows: original empirical research with quantitative, qualitative, or mixed methods; research participants were DC people, gamete donors, and/or parents interested in searching for people (genetically) related to them through gamete donation; and a substantial part of the article focused on searching for or an interest in contacting donor-related people. The exclusion criteria were as follows: publications other than original peer-reviewed research and publications on known donors and &lt;/span&gt;surrogacy. Methodological quality was assessed using the Critical Appraisal Skills Program checklist for qualitative studies and the Joanna Briggs Institute Critical Appraisal Checklist for quantitative studies. Eligibility assessments, quality assessments, and data extraction were independently performed by 2 teams, with disagreements resolved by discussion.&lt;/span&gt;&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;An initial search yielded 4,040 publications, of which 119 articles were full-text screened and 47 studies were included for review. The studies were diverse in design, setting, recruitment methods, data collection, and stakeholder groups. The DC people, parents, and donors of the studies included had an interest in each other; however, their motives, desired information, and/or expectations regarding their interest and/or seeking contact differed. Among the participants in the studies, the interests of the DC people, parents, and donors were intertwined and not necessarily in conflict. Methodological limitations of the included studies were identified.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;p&gt;Donor linking occurred in a complex array of several factors: psychosocial, sociodemographic, relational, and environmental variables. Further research is needed to better understand the relative influence of these variables and identify the psychosocial needs of the different groups. Preliminary findings showed that stakeholders can have an interest in an ongoing contact. However, the studies’ methodological shortcomings limited the extent to which these findings could be applied to all people interested in donor-related contact. Follow-up research is needed on what happens after parties are li","PeriodicalId":73011,"journal":{"name":"F&S reviews","volume":"2 2","pages":"Pages 93-119"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.xfnr.2021.01.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48651309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preconceptual care for couples seeking fertility treatment, an evidence-based approach","authors":"Elpiniki Chronopoulou M.Sc., M.R.C.O.G. ,&nbsp;Amelia Seifalian M.B.B.S. ,&nbsp;Judith Stephenson F.F.P.H. ,&nbsp;Paul Serhal F.R.C.O.G. ,&nbsp;Wael Saab M.D., M.R.C.O.G. ,&nbsp;Srividya Seshadri M.Sc., M.D., M.R.C.O.G.","doi":"10.1016/j.xfnr.2020.09.001","DOIUrl":"10.1016/j.xfnr.2020.09.001","url":null,"abstract":"<div><p><span>There is accumulating evidence demonstrating that positive lifestyle modification and the optimization of the preconceptual period can influence the reproductive potential for both men and women. However, a large percentage of couples attending fertility clinics with potential to improve preconception habits may not always receive appropriate preconceptual advice. In addition, supplements and adjuncts that promise to increase fertility treatment success rates are marketed to infertile patients despite lack of convincing evidence supporting their benefit. This review aims to identify possible associations between lifestyle factors for couples seeking fertility treatment and fertility treatment outcomes and to offer possible explanations of the biological basis of these associations. An electronic search was conducted from 1978 through July 2019 linking preconceptual behaviors for women and men with the outcome of fertility treatment. The literature search explored the importance of numerous factors, including smoking, caffeine, alcohol, obesity, physical exercise, recreational drugs, stress, diet, supplements, </span>alternative medicine, environmental factors, and pollutants. Some associations were found to be more significant than others. The preconceptual period is undeniably a delicate and important window which should not be overlooked during fertility counseling. Simple lifestyle modifications could positively influence fertility treatment outcomes. Fertility teams, consisting of clinicians, fertility nurses, dieticians, psychologists, exercise advisors and others, should dedicate time to offer evidence-based preconceptual advice and targeted interventions to couples seeking fertility treatment.</p></div>","PeriodicalId":73011,"journal":{"name":"F&S reviews","volume":"2 1","pages":"Pages 57-74"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.xfnr.2020.09.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"107538329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preimplantation genetic testing: a review of current modalities","authors":"Benjamin S. Harris M.D., M.P.H. ,&nbsp;Katherine C. Bishop M.D. ,&nbsp;Jeffrey A. Kuller M.D. ,&nbsp;Sarah Alkilany B.S. ,&nbsp;Thomas M. Price M.D.","doi":"10.1016/j.xfnr.2020.10.001","DOIUrl":"10.1016/j.xfnr.2020.10.001","url":null,"abstract":"<div><p>In this review, we evaluate the different modalities of embryo genetic testing including preimplantation genetic testing for aneuploidy<span><span><span> (PGT-A), for monogenic/single-gene abnormalities (PGT-M), and for chromosomal structural rearrangements (PGT-SR), with a clinical focus on indications, strengths, limitations, and testing parameters of each technique. Articles were obtained from PubMed and American College Obstetricians and Gynecologists and American Society Reproductive Medicine committee opinions. While some studies have suggested that PGT-A increases live births in women of advanced maternal age, a recent large </span>randomized controlled trial<span> has shown no benefit to PGT-A compared with morphology grading alone, including in the subgroup of women &gt;35 years of age. Aneuploidy screening shortens the time to live birth in women with advanced maternal age. However, PGT-A is not without risk (false positive and false negative and “no read” results and embryonic damage), has significant financial cost, and should only be used in conjunction with genetic counseling and under the supervision of a qualified infertility subspecialist. PGT-A is most cost-effective among women ≥38 years of age. PGT-M and PGT-SR offer useful low-risk screening modalities for debilitating inherited disorders. Significant advances have been made in the ability to analyze </span></span>human embryos<span> for genetic abnormalities. Screening for monogenic and chromosomal structural abnormalities potentially eliminates disease transmission to subsequent generations. Optimization of these molecular techniques remains necessary to decrease the false positive rates. Additional study of embryo mosaicism is needed to clarify which embryos are appropriate for transfer.</span></span></p></div>","PeriodicalId":73011,"journal":{"name":"F&S reviews","volume":"2 1","pages":"Pages 43-56"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.xfnr.2020.10.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47715636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting the outcomes of assisted reproductive technology treatments: a systematic review and quality assessment of prediction models","authors":"Ian Henderson M.Sc. ,&nbsp;Michael P. Rimmer M.Sc. ,&nbsp;Stephen D. Keay M.D. ,&nbsp;Paul Sutcliffe Ph.D. ,&nbsp;Khalid S. Khan M.Sc. ,&nbsp;Ephia Yasmin Ph.D. ,&nbsp;Bassel H. Al Wattar Ph.D.","doi":"10.1016/j.xfnr.2020.11.002","DOIUrl":"10.1016/j.xfnr.2020.11.002","url":null,"abstract":"<div><h3>Objective</h3><p><span><span>Predicting the outcomes of assisted reproductive technology (ART) </span>treatments is desirable, but adopting prediction models into clinical practice remains limited. We aimed to review available prediction models for ART treatments by conducting a </span>systematic review of the literature to identify the best-performing models for their accuracy, generalizability, and applicability.</p></div><div><h3>Evidence review</h3><p>We searched electronic databases (MEDLINE, EMBASE, and CENTRAL) until June 2020. We included studies reporting on the development or evaluation of models predicting the reproductive outcomes before (pre-ART) or after (intra-ART) starting treatment in couples undergoing any ART treatment. We evaluated the models’ discrimination, calibration, type of validation, and any implementation tools for clinical practice.</p></div><div><h3>Results</h3><p><span>We included 69 cohort studies<span> reporting on 120 unique prediction models. Half of the studies reported on pre-ART (48%) and half on intra-ART (56%) prediction models. The commonest predictors used were maternal age (90%), tubal factor subfertility (50%), and </span></span>embryo quality (60%). Only 14 models were externally validated (14/120, 12%), including 8 pre-ART models (Templeton, Nelson, LaMarca, McLernon, Arvis, and the Stolwijk A/I, C, II models) and 5 intra-ART models (Cai, Hunault, van Loendersloot, Meijerink, Stolwijk B, and the McLernon posttreatment model), with a reported c-statistic ranging from 0.50 to 0.78. Ten of these models provided implementation tools for clinical practice, with only 2 reporting online calculators.</p></div><div><h3>Conclusion</h3><p>We identified externally validated prediction models that could be used to advise couples undergoing ART treatments on their reproductive outcomes. The quality of the available models remains limited and more research is needed to improve their generalizability and applicability into clinical practice.</p></div>","PeriodicalId":73011,"journal":{"name":"F&S reviews","volume":"2 1","pages":"Pages 1-10"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.xfnr.2020.11.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41417798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}